Mr. Golden Sun! Dr. Denton Says, With Spring in the Air, Get Some Sun!

Sun, properly received as a gift from God, is the greatest source for Vitamin D and helps us to live our lives to the full

Mr. Sunshine is Mr. Vitamin D!  Like most of the Nation, we are experiencing a wonderful gift as we move toward the end of Lent and the celebration of the Resurrection - an early Spring! I say "BRING IT ON!" Now is the time to shake off the winter blues and get out into the sunshine. You see, the Lord has a plan to revive us on every front, including our physical and emotional health.

PORTSMOUTH, VA. (Catholic Online) - Like most of the Nation we are experiencing a wonderful gift as we move toward the end of Lent and the celebration of the Resurrection - an early Spring! I say "BRING IT ON!" Now is the time to shake off the winter blues and get out into the sunshine. You see, the Lord has a plan to revive us on every front, including our physical and emotional health - and the Sun is one of His greatest gifts. 
 
With all of the concern arising out of the potentially dangerous effects of too much sun exposure, at this time of year I emphasize the importance of getting outside and enjoying the great gift of 'Mr. Golden Sun".You see, the Sun is meant to be our friend. It has amazing therapeutic benefits which help us live beautifully, as integrated human persons, body, soul and spirit. Of course, as with everything in our lives, it takes our exercise of wisdom to determine how to use this gift properly.  

Sun - blocks prevent penetration of light waves from stimulating the transition of cholesterol (cutaneous 7-dehydrocholesterol) to Vitamin D in the body. Even though we worry about the potential risks of sun exposure, what about our need for Vitamin D and its benefits? It is real and it is vitally important to our well being.

Vitamin D is a fat-soluble vitamin that acts more like a hormone than a vitamin. Vitamin D can come from food, but is largely made in the body after ultraviolet light (sunshine) stimulates the conversion of cholesterol type compounds to become Vitamin D. The Vitamin D then goes through two modifications in the liver calcidiol - (25-hydroxyvitamin D) = 25(OH) D)- and the kidneys, where it becomes activated.

The active Vitamin D is called calcitriol - (1.25-dihydroxyvitamin D) = 1.25(OH)2D.). Once activated the Vitamin D sticks around for 15 - 20 hours (half-life 15 hours). Think of it this way single numbered Vitamin D 25 on the team is the storage guy, once he gets the #1 put on his chest - 1.25(OH)2D - he gets his confidence up and starts getting active telling the body what to do. Simply put, sunshine hits our skin and it all begins to happen. The skin converts some type of cholesterol to form Vitamin D. This Vitamin D has to go to the liver and then the kidneys to become a form of Vitamin D that is useful to the body.

In addition, Vitamin D is largely known for its bone function. By promoting calcium absorption from the gut, Vitamin D stabilizes the serum levels necessary for normal muscle and bone function. Approximately 99% of this calcium goes into bone. The remainder plays a role in cell membrane bioelectrical balance, the electrical charge across a cell membrane allows the cell to gain nutrients and rid itself of waste. The mineralization of bone is largely modulated via Vitamin D and its effects on osteoblasts and osteoclasts. These are both little cells that make and remove bone.

A lack of Vitamin D leads to brittle and thinned bone. Calcium and Vitamin D combine to protect us from these bone diseases (i.e. osteoporosis). Although rarely mentioned, Vitamin D has beneficial effects on immune function, inflammation reduction, and cell proliferation/death.

When testing for Vitamin D deficiency, the storage level is measured, not the active form in the system. This is because the storage form is a better measure of the bodies overall Vitamin D levels. "Rickets disease" is the most common terminology used for Vitamin D deficiency. It is often seen in children. For example, soft long bones leading to bowed legs.

One of the most confusing things about nutrition is the challenge of understanding the terminology used for what we need daily to live beautiful healthy lives. Dietary Reference Intakes (DRIs) is the term used for a set of reference values used to determine nutrient intakes to sustain healthy humans. These reference values are the Recommended Dietary Allowance (RDA), Adequate Intake (AI), and Tolerable Upper Intake Level (UL). You will see these letters in multiple articles as well as on food containers.

- Recommended Dietary Allowance (RDA): daily level of intake sufficient to meet the nutrient requirements of (97-98%) healthy people.
- Adequate Intake (AI): when an RDA cannot be set because of insufficient data the AI is set at a level assumed to ensure nutritional adequacy.
- Tolerable Upper Intake Level (UL): maximum safe daily intake

Another confusing part about vitamins and the dosing is the amount listed can be in micrograms, milligrams, or even international units. The Adequate Intake (AI) for Vitamin D is listed in either micrograms (mcg) and or International Units (IUs). 1 microgram is equal to 40 IUs. The Adequate Intake levels were established with the assumption that the individual is not producing vitamin D through sun exposure.

SUN, SUN, SUN, oh HAPPY SUN.

WAIT A Minute. didn't I write an article on the necessity of sun protection last year? Once again, the balance of too little and too much becomes clear. O.K. you may ask, but how about some guidelines? Here are some helps as you guide yourself through using your own human wisdom, educated by reading and studying good health sources. and then live your life trusting the Lord who made you and has a wonderful plan for you.  

Most people get their Vitamin D from the sun. Sunlight above the 42 degrees N. latitude (Northern California - Boston) from March through October will have enough intensity to give you a Vitamin D dose. The other four months are a problem. 34 degrees N. (L.A. to Charleston S.C.) and below has an intensity of sun to give the body enough Vitamin D year around.

Shade reduces UV energy by as much as 60%. UVB doesn't pass through glass so Vitamin D doesn't get produced while driving home. Please get out and walk!! What about the sun block I recommended earlier. SPF of 8 or higher blocks Vitamin D production. Some vitamin D researchers recommend 5-30 minutes of sun exposure between 10 AM and 3 PM twice a week to the face, arms, legs, or exposed back without sunscreen will provide adequate vitamin D production.

SO... get your sunlight when? I personally tell my patients to get their exposure before 9 in the morning or after 5 in the afternoon. If you are fair skinned and burn easily (that is Fitzpatrick 1 or 2, light skinned Irish) then 10 - 15 minutes a minimum of twice per week, and daily and if you don't take in any Vitamin D in your diet. Remember if you live North of LA or Charleston you have to take in some form of Vitamin D by the food you eat or as a supplement! If you are dark skinned and rarely if ever burn (Fitzpatrick 3 or 4) you need twice as much sun exposure because the melanin in your skin decreases the penetration of the sunlight.

Obviously we can't get enough sun to produce vitamin D and still protect our skin from sun damage such as skin cancer, photo-aging, or pigment abnormities. So, what can we do? Diet and supplements play a key role. Fresh fish has the highest concentration of Vitamin D. Salmon, once again, is high on the list of the healthiest foods on the planet. Tuna, mackerel, and cod are also ideal. Smaller amounts of Vitamin D can come from foods such as beef liver, egg yolks and cheese. Fortified milk is a way to increase the bodies Vitamin D. Other foods fortified with Viamin D include breakfast cereals and calcium fortified juices.

As for dietary supplements, there are two forms D2 (ergocalciferol) and D3 (cholecaliferol). Both of these forms of Vitamin D will increase the serum 25(OH)D levels, but new research indicates that Vitamin D3 may be three times more effective.

So, you still don't think you have to worry about a getting enough Vitamin D? Hang in there, Dr Denton is throwing a lot at you again. I can almost hear my readers.Please - get to the point.

Those of us who should take dietary supplements include: breast fed only infants, individuals with limited light exposure, patients with fat malabsorption problems, overweight individuals with a BMI of >30, and individuals over the age of 50 outside of the sun belt.

Infants:

Vitamin D requirements cannot be achieved on breast milk alone. Now that we have begun to limit the sun exposure of our infants (recommended by the American Academy of Pediatrics) we need to be aware of supplementing our infants with Vitamin D. The Academies recommendations are clear: Partially or completely breastfed infants need 400 IU per day.

Senior adults:

If you are over 50 you are at an increased risk for reduced Vit. D levels. Remember this is not just about osteoporosis this in also about immune function and cancer prevention. Research has looked at the Vit. D levels in hip fracture patients and nearly half of those studied had decreased levels of Vit. D.

Dark Skinned people (Fitzpatrick scale 4 or higher = rarely burn in the sun):

Melanin in the skin decreases the body's ability to produce Vitamin D. It acts much like sun-blocks. Because of this, many studies have looked at Vitamin D levels in patients with dark skin. The highest incidence of rickets in America is in African American infants who are solely breast fed. Other results demonstrate lower levels of Vitamin D especially in senior women. Interestingly the one group of patients with decreased Vitamin D levels, yet fewer hip fractures than light skin patients, is senior African Americans. The reason is thought to be higher bone density development prior to menopause.

Fat-malabsorption:

Vitamin D is a fat soluble vitamin and therefore you need to include some fat in your meals to allow absorption. Fat malabsorption is seen in patients with Crohn's disease, cystic fibrosis, liver and pancreatic disease, celiac disease, stomach and or intestine resection, and yes by-pass patients.

NOW let's take this One Step Further. If you are a senior on a low-fat diet high fiber diet, not only are you not getting enough brain food you're not absorbing enough Vitamin D. So we should ask, "Have we fed the Heart and Starved the Brain and the Bones?"

My Great grandmothers voice comes to mind take your cod liver oil daily it will keep you healthy.YUK, right? Interestingly, she had no osteoporosis well into her 80s. Now it all makes sense the cod liver oil was high in Vitamin D and fish oil fat was its carrier, The perfect combination for Vitamin D absorption. Oh, by the way, she didn't have heart disease either.

Obesity: (BMI)

If your body mass index (BMI) you have a high incidence of low serum levels of 25(OH). Subcutaneous fat (fat in our bodies just under the skin) holds onto the Vitamin D produced by the skin and slows its release to the rest of the body.

Food for thought: We, as a nation, are considered to be 50% obese. We have been on a low fat high fiber diet, and more recently high protein diets have become in vogue. Vitamin D in our supplements, without some fat in our gut, is useless! Sun exposure is reduced and we send many of our senior to facilities where sun exposure is largely limited to windows. Clearly there is No Vitamin D there!

The answer is simple:

Mr. Sunshine is Mr. Vitamin D! A little SUN in the morning or evening, reduced fat --not "no fat" milk --- cod liver oil capsule, fish oil is the best! Do you love salmon? All of this is meant to say, have some fat, yes some fat, with that Vitamin D3 supplement. The simplest way is to have a little olive oil on the salad and remember if the sun looks beautiful that is because it is! Properly received, it can help you on the path to beautiful living!

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Dr Denton D. Weiss, M.D. is board certified in both Plastic and Reconstructive Surgery and Otolaryngology-Head and Neck Surgery. Dr. Weiss' approach to his medical practice flows from his convictions about the meaning of life which are deeply rooted in his Catholic Faith. He and his wife, Michelle strive for an integrated approach to life which recognizes the unity of the body, mind and soul. They call this approach "Bella Vitae". or "Beautiful Living". He is a contributing writer to Catholic Online.

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